| NPI | 1407403538 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9394351)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP9394351)  | 
| Enumeration Date | 2019-08-22 | 
| Last Update Date | 2023-04-10 |