| NPI | 1306430681 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24708) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 24708) | 
| Enumeration Date | 2021-02-26 | 
| Last Update Date | 2021-04-22 |