| NPI | 1336507250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704380244) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024173458) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP 60624672) | |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2023-07-07 |