| NPI | 1124625140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 305664) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704360099) |
| 363L00000X Nurse Practitioner (Licence: CO APN.0996847-NP) | |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2024-07-19 |