| NPI | 1376051235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA AP09733) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 04576) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2021-07-29 |