| NPI | 1154763514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 11016785) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R855653) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2025-05-10 |