| NPI | 1508738691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11041231) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-002701) |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2025-12-03 |