| NPI | 1487054730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 65594) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO 0991147) |
| Enumeration Date | 2014-08-23 |
| Last Update Date | 2021-10-25 |