| NPI | 1720336910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: AZ AP10652) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 66001) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3007628) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP10652) | |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2024-01-08 |