| NPI | 1902294358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN 6699) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 6699) |
| 363L00000X Nurse Practitioner (Licence: CT 6046) | |
| 363LF0000X Nurse Practitioner Family (Licence: MA RN2284104) | |
| 363LF0000X Nurse Practitioner Family (Licence: CT 6046) | |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2022-06-01 |