| NPI | 1871592238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP-707A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-186875) |
| 363L00000X Nurse Practitioner (Licence: WA AP30006762) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2024-08-22 |