| NPI | 1811480106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010580) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 303608) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 303608) | |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2022-03-01 |