| NPI | 1649862335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 905679) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 880054) |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2023-01-15 |