| NPI | 1619632973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 263304) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 263304) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2026-05-05 |