| NPI | 1366056962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11026537) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9631119) |
| 363L00000X Nurse Practitioner (Licence: CT 10998) | |
| 163W00000X Registered Nurse (Licence: CT 121106) | |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2024-02-23 |