| NPI | 1417315318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2019003239) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 363LF0000X Nurse Practitioner Family (Licence: AR A004640) | |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2023-10-03 |