| NPI | 1396261293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 53050) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP018039) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP018039) | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2024-03-08 |