| NPI | 1902034002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004400) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004400) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 20605) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2024-05-06 |