| NPI | 1053781310 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9279303) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 28079) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1111711) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5021593) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 35911) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001654) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 0038093) | |
| Enumeration Date | 2015-09-30 | 
| Last Update Date | 2025-02-06 |