| NPI | 1750380192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006141) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC nc5006141) |
| 363L00000X Nurse Practitioner (Licence: SC 18073) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2021-09-22 |