| NPI | 1255821062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 051672-23) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: SC 21636A) |
| 363L00000X Nurse Practitioner (Licence: SC 21636A) | |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2023-11-17 |