| NPI | 1194120642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL APRN9225787) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9225787) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2020-12-11 |