| NPI | 1750936522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 71672) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 57250) |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2022-03-31 |