| NPI | 1114780723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA 61506444) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1106827) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 10605) | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-02-05 |