| NPI | 1508598434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC AG06220020) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1085589) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2025-09-29 |