| NPI | 1396417341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ 264521) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care (Licence: AZ 264521) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2021-10-05 |