| NPI | 1902923055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 900370) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 900370) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002773) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-24 |