| NPI | 1407543085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R188706) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL TPAN1785) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188461) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 13534537-4405) | |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2024-03-16 |