| NPI | 1376213504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA 13306929) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA F09210778) |
| Enumeration Date | 2021-09-19 |
| Last Update Date | 2022-10-26 |