| NPI | 1811392103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024175395) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201500384NP-PP) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704288222) | |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2024-01-10 |