| NPI | 1801945837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5001747) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5001747) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 005001747) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2022-08-24 |