| NPI | 1982029666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: ID NP-1410A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1410A) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201401211NP-PP) | |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2024-05-15 |