| NPI | 1598142648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017320) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NC 81366) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC TABR-6V19Z) | |
| 363L00000X Nurse Practitioner (Licence: NC 5017320) | |
| 164W00000X Licensed Practical Nurse (Licence: NY 303770) | |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2026-02-26 |