| NPI | 1578088985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 53377) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000022126) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2018-08-17 |