| NPI | 1962164376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MD R194107) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: MD R194107) |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2021-10-14 |