| NPI | 1770829277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5006005) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: NC 5006005) |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2022-08-02 |