| NPI | 1316419542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 5018067) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5018067) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5018067) | |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2023-12-18 |