| NPI | 1902015050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A-118212) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA G118212) |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 15627.0170) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-04-05 |