| NPI | 1912581034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 67579) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 257269) |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2022-12-22 |