| NPI | 1134858624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IA A169455) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA A169455) |
| 163W00000X Registered Nurse (Licence: IA 109367) | |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-07-11 |