| NPI | 1942779475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011322) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC AG11180027) |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2023-03-22 |