| NPI | 1164685210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 74281) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP3281) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201050195NP) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2023-09-25 |