| NPI | 1033823430 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 11036780)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9583885)  | 
| Enumeration Date | 2023-01-10 | 
| Last Update Date | 2024-12-12 |