| NPI | 1700103512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9267258) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 29897) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5007185) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 37998) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 0038040) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2025002556) | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2025-02-05 |