| NPI | 1174127054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95017143) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN281123) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 95017143) | |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2023-10-31 |