| NPI | 1861578635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 863841) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R863841) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA RN109495 APO4933) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2022-08-26 |