| NPI | 1982061024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0993641) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0103086) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5008415) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 1979-2A) | |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2020-08-26 |