| NPI | 1225590888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5011634) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011634) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2022-05-12 |