| NPI | 1326652579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL APRN11008623) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG-0012890) |
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0012890) | |
| 207Q00000X Family Medicine (Licence: CA 95038266) | |
| 207Q00000X Family Medicine (Licence: MO 2020023118) | |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2026-02-05 |