| NPI | 1700275724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 65678) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007413) |
| 163W00000X Registered Nurse (Licence: NC 247533) | |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2022-03-14 |