| NPI | 1114705035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 75595) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM 75595) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2024-10-11 |