| NPI | 1063976546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 22723) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22723) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: SC 22723) | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2024-05-06 |