| NPI | 1154621423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OK 83097) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN182800) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306010) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 20472) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: NY 421072) | |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2021-06-18 |