| 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 |