| NPI | 1609396076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 902135) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 894342) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2023-01-25 |