| NPI | 1326414137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008336) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 20002RX) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 20002) | |
| Enumeration Date | 2015-08-16 |
| Last Update Date | 2023-02-09 |