| NPI | 1922589704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 22188) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 22188) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2021-12-08 |