| NPI | 1396045134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 62170) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 22034) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2258804) | |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2022-02-25 |