| NPI | 1376159939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 156026) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010109) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2023-04-24 |