| NPI | 1417979774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 110721) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 110721) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-09-15 |