| NPI | 1558608067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 26862) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD CP001709) |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2013000129) | |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2023-03-27 |