| NPI | 1780163550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016904) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R211716) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP019653) | |
| Enumeration Date | 2018-08-12 |
| Last Update Date | 2022-10-20 |