| NPI | 1215504410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA A163396) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A163396) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2021-07-21 |