| NPI | 1508593260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DC NP500004231) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP025927) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: DC NP500004231) | |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2022-10-20 |