| NPI | 1386945558 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4550)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP10508)  | 
| 363L00000X Nurse Practitioner (Licence: WA AP60191449)  | |
| 363L00000X Nurse Practitioner (Licence: NY F421572-01)  | |
| 363L00000X Nurse Practitioner (Licence: CO 0003823)  | |
| 363L00000X Nurse Practitioner (Licence: IA F170074)  | |
| 363L00000X Nurse Practitioner (Licence: IL 209-010404)  | |
| Enumeration Date | 2010-11-04 | 
| Last Update Date | 2023-11-03 |