| NPI | 1689297715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC AG0520065) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 5013602) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5013602) | |
| Enumeration Date | 2020-05-23 |
| Last Update Date | 2022-07-14 |