| NPI | 1386315158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015099) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC BAKK-N6SJJ) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2381719) | |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2024-08-29 |