| NPI | 1194979211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP04212) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN085964) |
| 363LS0200X Nurse Practitioner, School (Licence: LA AP04212) | |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2021-05-19 |