| NPI | 1245886100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: MS 906629) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NM 70819) |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 1-133463) | |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2024-06-03 |