| NPI | 1194912485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5003617) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 4187) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 152220) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2021-12-09 |