| NPI | 1295456184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA A170959) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IA A170959) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A170959) | |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-10-19 |