| NPI | 1245373463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 201952) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 172789) |
| 363L00000X Nurse Practitioner (Licence: NC 172789) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2023-03-07 |