| NPI | 1912068164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R193373) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45290) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 684798) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181660) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2024-12-11 |