| NPI | 1154957215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ 239604) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: UT 13742545-4405) |
| 363LF0000X Nurse Practitioner Family (Licence: OR 202011282NP-PP) | |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2024-02-19 |