| NPI | 1962191973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 73177) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM 73177) |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2023-05-25 |