| NPI | 1023489556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 29952) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA.18165-NP) |
| 363LF0000X Nurse Practitioner Family (Licence: CO 0994265) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2024-09-04 |