| NPI | 1164646659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN270748) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL ARNP9370385) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007423) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 20340) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9370385) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2019-04-15 |