| NPI | 1164875654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R185941) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD R185941) |
| 163W00000X Registered Nurse (Licence: MD R185941) | |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2022-11-23 |