| NPI | 1891932810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111499) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-132154) |
| 363L00000X Nurse Practitioner (Licence: MO 2003004347) | |
| 163W00000X Registered Nurse (Licence: NE 75780) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9373824) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 111499) | |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2020-12-27 |