| NPI | 1154898179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 22378) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22378) |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2025-12-30 |