| NPI | 1407020589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5004259) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 3535) |
| 363L00000X Nurse Practitioner (Licence: NC 5004259) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC F3535) | |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2023-06-22 |