| NPI | 1770509572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 2680) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 2680) |
| 363L00000X Nurse Practitioner (Licence: NC 5011611) | |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5011611) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-04-07 |