| NPI | 1164831251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 289311) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9945-33) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2283371) | |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2023-10-17 |