| NPI | 1356985170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 58290) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 58290) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2025-06-17 |