| 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 |