| NPI | 1821054024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202006390NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F334032-1) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9378277) | |
| 363L00000X Nurse Practitioner (Licence: NM 54628) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 54628) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 10945) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2025-09-10 |