| NPI | 1982055257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008981) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 20261) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2023-06-22 |