| NPI | 1134836828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD AC004748) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TPAN3581) |
| 363LF0000X Nurse Practitioner Family (Licence: NY F350847) | |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024187951) | |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2025-08-24 |