| NPI | 1003643529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 37302) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: MS 906876) |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2024-11-19 |