| NPI | 1891140430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 74826) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 120582) |
| 363L00000X Nurse Practitioner (Licence: NM 74826) | |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 200449) | |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2023-10-20 |