| NPI | 1417623695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5014908) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 5014908) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5014908) | |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-08-18 |