| NPI | 1891422853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 905478) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 905478) |
| 363L00000X Nurse Practitioner (Licence: LA 227359) | |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2023-07-18 |