| NPI | 1669901765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 112268) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 72499) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2020-05-20 |