| NPI | 1831600410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NC 339749) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 661151) |
| 363L00000X Nurse Practitioner (Licence: TX 661151) | |
| 363LF0000X Nurse Practitioner Family (Licence: TX 661151) | |
| 363LW0102X Nurse Practitioner Women's Health (Licence: TX 5009996) | |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2022-02-16 |