| NPI | 1134614050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC AG06180130) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010732) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5010732) | |
| Enumeration Date | 2018-06-23 |
| Last Update Date | 2020-03-20 |