| NPI | 1669191870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 00000) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5016817) |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2023-01-11 |