| NPI | 1508241902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 294437) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 20368) |
| 363L00000X Nurse Practitioner (Licence: NC 275379) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 20368) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 275379) | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2023-11-15 |