| NPI | 1568894731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA A089557) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A089557) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2020-03-05 |