| NPI | 1912558388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014834) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014834) |
| 207Q00000X Family Medicine (Licence: AZ 232652) | |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2022-12-19 |