| NPI | 1245424761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014370) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO 5334) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 122656) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2021-09-13 |