| NPI | 1164968749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA 2345722) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VT 101.0134229) |
| 363LF0000X Nurse Practitioner Family (Licence: TX AP132850) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: ME 221431) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: TX AP132850) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: CO APN.0995662) | |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2023-06-05 |