| NPI | 1376257089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL F01230294) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AL 1-166477) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-10-04 |