| NPI | 1578951240 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 237427) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS R878829) | 
| 363LF0000X Nurse Practitioner, Family (Licence: MS R878829) | |
| Enumeration Date | 2015-01-05 | 
| Last Update Date | 2024-10-22 |