| NPI | 1114530045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A159848) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 11452) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 15342-33) | |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2024-08-14 |