| NPI | 1073108791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11011976) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: FL F02211231) |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2021-03-04 |