| NPI | 1083054423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IA A172297) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 184678) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5006258) | |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2023-03-22 |