| NPI | 1992105092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A155683) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 119451) |
| 363L00000X Nurse Practitioner (Licence: NE 112229) | |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2022-01-05 |