| NPI | 1861437980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61479503) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD CP000450) |
| 363LF0000X Nurse Practitioner Family (Licence: WY 33105.1295) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2023-10-02 |