| NPI | 1912306341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R40921) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NE 111675) |
| 363L00000X Nurse Practitioner (Licence: MN 8737) | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2022-02-25 |