| NPI | 1669996062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: VA 0024175178) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: VA 0024175178) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: VA 0024175178) | |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2021-12-31 |