| NPI | 1780046250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NM 65631) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2016007832) |
| 363LF0000X Nurse Practitioner Family (Licence: KS 53-77077-022) | |
| 363LF0000X Nurse Practitioner Family (Licence: NE 112929) | |
| 363LF0000X Nurse Practitioner Family (Licence: MI 4704380095) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2022-11-16 |