| NPI | 1518242874 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005701) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95013380) | 
| 363L00000X Nurse Practitioner (Licence: MI 4704244143) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5005701) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 26803) | |
| Enumeration Date | 2011-10-19 | 
| Last Update Date | 2025-05-28 |