| NPI | 1427597053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112157) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 112157) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A142416) | |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2020-10-06 |