| NPI | 1508161274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC002938) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC RN1013720) |
| 163W00000X Registered Nurse (Licence: NC 159465) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704358855) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 159465) | |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2020-11-09 |