| NPI | 1255756169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IA H170500) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 70015) |
| 363LF0000X Nurse Practitioner Family (Licence: NE 113888) | |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2022-08-28 |