| NPI | 1457870743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 1-092388) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902301) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2019-09-17 |