| NPI | 1386306355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 1316962590) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 1316962590) |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2025-03-19 |