| NPI | 1275194748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 0996780) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: WY 43940) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2023-05-22 |