| NPI | 1760112957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD 210110) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD R210110) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2023-10-30 |