| NPI | 1649905159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA 226795) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 226795) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2023-07-05 |