| NPI | 1578244828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA F06231776) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA F06231776) |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2023-08-07 |