| NPI | 1174961445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3008234) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 150129) |
| 163W00000X Registered Nurse (Licence: AK NURR32203) | |
| 163W00000X Registered Nurse (Licence: CA 748877) | |
| 163W00000X Registered Nurse (Licence: NY 634916) | |
| 363LF0000X Nurse Practitioner Family (Licence: TN 21503) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2021-09-29 |