| NPI | 1366863888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS F06172114) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 190604) |
| 163WC0200X Registered Nurse Critical Care Medicine (Licence: TN 190604) | |
| 363L00000X Nurse Practitioner (Licence: MS F06172114) | |
| 363LC1500X Nurse Practitioner Community Health (Licence: MS F06172114) | |
| 363LF0000X Nurse Practitioner Family (Licence: CA 95007880) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MS F06172114) | |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2020-07-16 |