| NPI | 1366102964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R251439) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD R251439) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2022-10-04 |