| NPI | 1760964506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM CNP-53780) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM CNP-53780) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |