| NPI | 1972941441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A181147) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 111480) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 111480) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2024-10-15 |