| NPI | 1447867148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013976) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 232925) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5013976) | |
| Enumeration Date | 2020-09-26 |
| Last Update Date | 2022-08-02 |