| NPI | 1912334970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5006536) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006536) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NC 5006536) | |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2022-03-25 |