| NPI | 1063096691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA SP024460) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A163323) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2021-11-07 |