| NPI | 1124025556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200825) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 200825) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2021-11-05 |