| NPI | 1417476987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 57114) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60814176) |
| 363L00000X Nurse Practitioner (Licence: GA RN60075) | |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2022-03-18 |