| NPI | 1588365613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 60550) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 60550) |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2024-10-11 |