| NPI | 1386303964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 905081) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS GRAY-6PUGTY) |
| Enumeration Date | 2021-12-11 |
| Last Update Date | 2023-04-04 |