| NPI | 1184441602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: ND 200987) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: ND 200987) |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2024-10-17 |