| NPI | 1669809430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 9403548) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ 285092) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 32963) | |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024184952) | |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2023-02-06 |