| NPI | 1851352389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT 161179) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R867210) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 8395) | |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024170114) | |
| Enumeration Date | 2006-04-02 |
| Last Update Date | 2021-02-09 |