| NPI | 1649881178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013403) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5013403) |
| 363A00000X Physician Assistant (Licence: NC 5013403) | |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2022-06-20 |