| NPI | 1568959682 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL F04180293) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP9398403) | 
| Enumeration Date | 2018-04-13 | 
| Last Update Date | 2020-06-25 |