| NPI | 1639821374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 11018436) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 25450) |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2025-06-07 |