| NPI | 1093266470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11028996) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007002622) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95026969) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2016036906) | |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2024-07-22 |