| NPI | 1720704026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 70254) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NM 70254) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2024-09-13 |