| NPI | 1639715790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R194704) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0024178427) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: PA SPO21892) | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2024-06-09 |