| NPI | 1700423357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 64621) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 190565) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2022-01-13 |