| NPI | 1720635774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R207214) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R207214) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R207214) | |
| 363LC1500X Nurse Practitioner, Community Health (Licence: MD R207214) | |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: MD R207214) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R207214) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R207214) | |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: MD R207214) | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2022-01-17 |