| NPI | 1053969014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11032788) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL MO9002990) |
| 363LF0000X Nurse Practitioner Family (Licence: CO APN.0994708-NP) | |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2024-08-16 |