| NPI | 1255751608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV 834444) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 67290) |
| 363L00000X Nurse Practitioner (Licence: CA NP22523) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2021-05-21 |