| NPI | 1548799059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95016348) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: NY 717070) |
| 163WG0000X Registered Nurse General Practice (Licence: PA RN697842) | |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP018660) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2021-02-01 |