| NPI | 1619011699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 201368) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001113672) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2025-09-16 |