| NPI | 1043379456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 56878) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000151934) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 12390) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM APN56978) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2023-07-25 |