| NPI | 1174907679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9470582) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024189886) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0100353) | |
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0013020) | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2025-04-09 |