| NPI | 1801375191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD RN241344) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP019080) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2020-01-27 |