| NPI | 1396184362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006244) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 209505) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5006244) | |
| Enumeration Date | 2013-06-22 |
| Last Update Date | 2022-06-16 |