| NPI | 1043619919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 55543) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01427) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 76474) | |
| Enumeration Date | 2014-08-17 |
| Last Update Date | 2019-05-03 |