| NPI | 1053971796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ 226387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 226387) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2022-07-05 |