| NPI | 1275102717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014681) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024185096) |
| 207Q00000X Family Medicine (Licence: CO 0003034) | |
| 207Q00000X Family Medicine (Licence: SC 26328) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: IA a166704) | |
| Enumeration Date | 2021-06-20 |
| Last Update Date | 2025-11-08 |