| NPI | 1639722036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R122278) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R122278) |
| 363L00000X Nurse Practitioner (Licence: DE LP-0000319) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LP-0000319) | |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2021-01-22 |