| NPI | 1194774190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP65978) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP04732) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS R853759) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2022-01-10 |