| NPI | 1912629544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NV 858281) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: NV 858281) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2024-03-22 |