| NPI | 1275811572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 06554) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP06554) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP06554) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2022-04-28 |