| NPI | 1649846098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 24758) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 24758) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: SC 24758) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: SC 24758) | |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2021-05-27 |