| NPI | 1972721637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 62866) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC RN074855) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2008-01-21 |