| NPI | 1225454689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006818) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F0314049) |
| 163W00000X Registered Nurse (Licence: NC 178042) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 178042) | |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2020-10-21 |