| NPI | 1679094601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 5421070) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 21070) |
| 207Q00000X Family Medicine (Licence: SC 5421070) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2025-08-08 |