| NPI | 1306287552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111368) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111368) |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 12244A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 2474) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 3211213W) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201390420NP-PP) | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2017-01-17 |