| NPI | 1639640402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: ID NP-53580) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ID 53580) |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2024-02-27 |