| NPI | 1053913483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013806) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5013806) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2023-01-23 |