| NPI | 1306534961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 251122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ 251122) |
| 207Q00000X Family Medicine (Licence: FL 11028063) | |
| 363LF0000X Nurse Practitioner Family (Licence: FL 11028063) | |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-11-16 |