| NPI | 1528584273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 22883) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 60810803) |
| 363LF0000X Nurse Practitioner Family (Licence: MS 904315) | |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2023-01-24 |