| NPI | 1114393618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID N-40239) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-35924) |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1596A) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2024-04-16 |