| NPI | 1487480703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 69272) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM 69272) |
| 207Q00000X Family Medicine (Licence: NM 69272) | |
| 207R00000X Internal Medicine (Licence: NM 69272) | |
| 208D00000X General Practice (Licence: NM 69272) | |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2025-03-06 |