| NPI | 1255044269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 950722) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 905722) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 905722) | |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2023-01-04 |