| NPI | 1003417163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD AC003392) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD AC003392) |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2021-08-19 |