| NPI | 1780138479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 238751) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5008806) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2020-01-17 |