| NPI | 1629565403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 26311) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 231426) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5010474) | |
| 363LS0200X Nurse Practitioner, School (Licence: NC 5010474) | |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2022-08-09 |