| NPI | 1013389824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 216033) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9455453) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 20604) | |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2021-03-10 |