| NPI | 1790453793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 65039) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM 65039) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2021-11-11 |