| NPI | 1669805818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2013010840) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013010840) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2018-10-11 |