| NPI | 1114928157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 3114742) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 3114742) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: FL 3114742) | |
| 363LW0102X Nurse Practitioner Women's Health (Licence: FL 3114742) | |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2022-08-03 |