| NPI | 1922156298 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5000690)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173602)  | 
| Enumeration Date | 2007-01-05 | 
| Last Update Date | 2018-08-17 |