| NPI | 1245013150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018633) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC AG07230125) |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2023-08-15 |