| NPI | 1699423939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 261QU0200X Clinic/Center Urgent Care | |
| 363LF0000X Nurse Practitioner Family (Licence: MS 905257) | |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2023-06-30 |