| NPI | 1629601687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11019360) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 111981) |
| 363L00000X Nurse Practitioner (Licence: WA 11019360) | |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2024-05-01 |