| NPI | 1639820194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 907056) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: MS 25D2248675) |
| Enumeration Date | 2022-01-15 |
| Last Update Date | 2024-11-19 |