| NPI | 1043882699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT NUR-APRN-LIC-176635) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT NUR-APRN-LIC-176635) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2023-03-22 |