| NPI | 1942872692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 221555) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA 221555) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-11-23 |