| NPI | 1396102869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5010496) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010496) |
| 363L00000X Nurse Practitioner (Licence: MI 4704183004) | |
| 363L00000X Nurse Practitioner (Licence: NC 302172) | |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2022-08-25 |