| NPI | 1710230974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 76324) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60309072) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.024491) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2023-08-02 |