| NPI | 1164979746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9494444) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9494444) |
| 164W00000X Licensed Practical Nurse (Licence: IL 209013486) | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2022-07-12 |