| NPI | 1588264865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5018529) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2023-12-13 |