| NPI | 1942873013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TN 29887) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000227562) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-08-18 |