| NPI | 1326639162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11011323) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11011323) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11011323) | |
| 207Q00000X Family Medicine (Licence: FL 11011323) | |
| 363L00000X Nurse Practitioner (Licence: FL APRN11011323) | |
| 163W00000X Registered Nurse (Licence: FL 9311959) | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2022-02-04 |