| NPI | 1619453602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 22049) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22049) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2024-06-06 |