| NPI | 1588174502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 10630) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-78459-032) |
| 363L00000X Nurse Practitioner (Licence: CT 10630) | |
| 363L00000X Nurse Practitioner (Licence: NY 351766) | |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2017033175) | |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2024-05-30 |