NPI | 1386183622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 202D00000X Integrative Medicine (Licence: MT 124572) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT 124572) |
261QP2300X Clinic/Center, Primary Care (Licence: MT APRN124572) | |
Enumeration Date | 2017-02-20 |
Last Update Date | 2025-02-10 |