| NPI | 1679095350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016885) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 95005912) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: FL APRN11016885) | |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-08-15 |