| NPI | 1093141004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: SC 19117) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006460) |
| 363L00000X Nurse Practitioner (Licence: SC 19117) | |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2020-10-15 |