| NPI | 1205292455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD R190900) |
| 363LF0000X Nurse Practitioner Family (Licence: CA 95003121) | |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2024-07-24 |