| NPI | 1154088722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 1155633) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: WI 11556-33) |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2023-04-27 |