| NPI | 1811370877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 19602) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5008211) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5008211) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 19602) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2020-12-30 |