| NPI | 1255817367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 112555) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NE 112555) |
| 363L00000X Nurse Practitioner (Licence: NE 112555) | |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2024-01-26 |