| NPI | 1093028805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A149479) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 111149) |
| 363LF0000X Nurse Practitioner Family (Licence: IA A149479) | |
| 363LF0000X Nurse Practitioner Family (Licence: NE 111149) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G171495) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NE 111149) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2023-09-19 |