| NPI | 1689923054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5020617) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004072A) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2024-09-18 |