| NPI | 1710307103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 18873) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 18773) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2023-01-05 |