| NPI | 1700491974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016476) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 363LF0000X Nurse Practitioner, Family (Licence: NC WHAT-E4LA0) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: NC 5016476) | |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2022-08-03 |