| NPI | 1215434584 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R208116)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R208116)  | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R208116)  | |
| Enumeration Date | 2018-04-12 | 
| Last Update Date | 2024-05-22 |