| NPI | 1013536960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R193082) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MD R193082) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2023-08-25 |