| NPI | 1144730680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10010964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A111917) |
| 363L00000X Nurse Practitioner (Licence: IA A111917) | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-12-04 |