| NPI | 1831479146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0994739) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024170146) |
| 363L00000X Nurse Practitioner (Licence: WI 4510-33) | |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2019-07-10 |