| NPI | 1780874081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A154489) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9423192) |
| 363L00000X Nurse Practitioner (Licence: MN R1664089) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2022-06-02 |