| NPI | 1780283457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 215794) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 215794) |
| 163W00000X Registered Nurse (Licence: LA RN099064) | |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2021-08-23 |