| NPI | 1598141822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 1639105695) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704278593) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2020-12-15 |