| NPI | 1295407146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA RN674161) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2023-08-21 |