| NPI | 1710359294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL APRN9299155) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL F1015080) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9299155) | |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2026-01-30 |