| NPI | 1578029419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019005030) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2022-03-21 |