| NPI | 1255975207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004835) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11004835) |
| Enumeration Date | 2019-11-02 |
| Last Update Date | 2020-10-06 |