| NPI | 1770191157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 214401) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 214401) |
| 207R00000X Internal Medicine (Licence: LA 214401) | |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2022-09-28 |