| NPI | 1962273342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11030236) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 363L00000X Nurse Practitioner (Licence: FL 11030236) | |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-04-17 |