| NPI | 1376901041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024279486) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307621) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2022-02-08 |