| NPI | 1053786558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008195) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC F0815168) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5008195) | |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2024-07-25 |