| NPI | 1780603522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 201753) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 97858) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-03-07 |