| NPI | 1114656071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 26583) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 104636) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-12-20 |