| NPI | 1053938803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R220031) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R220031) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R220031) | |
| Enumeration Date | 2020-06-27 |
| Last Update Date | 2023-04-24 |