| NPI | 1780253989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 39413) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 67570) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2024-05-03 |