| NPI | 1083178040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: APRN11001322) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11001322) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2024-09-05 |