| NPI | 1023396900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001180) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN623381) |
| 363L00000X Nurse Practitioner (Licence: MN R198045-9) | |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP011508) | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2019-10-31 |