| NPI | 1922747310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016629) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 5016629) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2022-08-10 |