| NPI | 1174276505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A167180) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IA a167180) |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2024-09-05 |