| NPI | 1366740219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA A182204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 232211) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.008668) | |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2025-02-05 |