| NPI | 1265926679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4704247277) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704247277) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2023-03-06 |