| NPI | 1487905253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 70365) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP 60283683) | |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2021-02-17 |