| NPI | 1942351333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 52020) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 259049) |
| 363L00000X Nurse Practitioner (Licence: CO 0990361) | |
| 363L00000X Nurse Practitioner (Licence: NH 057094-21) | |
| 363L00000X Nurse Practitioner (Licence: NH 057094-23-03) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2024-04-15 |