| NPI | 1790492916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5017154) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017154) |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2024-10-05 |