| NPI | 1790295483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 255601) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010002) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5010002) | |
| Enumeration Date | 2017-10-07 |
| Last Update Date | 2020-08-27 |