| NPI | 1184238438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95019090) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 2331579) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2331579) | |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2021-11-17 |