| NPI | 1659970739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: PA SP022683) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP022683) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2021-07-15 |