| NPI | 1053307090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201708253) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95193472) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 5173) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ME CNP211353) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60728469) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2023-01-09 |