| NPI | 1053887554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 215971) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 30244) |
| 363L00000X Nurse Practitioner (Licence: NC 5011948) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00870100) | |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2023-05-17 |