| NPI | 1881017382 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 53812) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9285241) | 
| Enumeration Date | 2014-02-04 | 
| Last Update Date | 2016-09-01 |