| NPI | 1528378122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R876991) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5017706) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5017706) | |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2023-11-15 |