| NPI | 1740077684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 83751) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 83751) |
| Enumeration Date | 2025-04-23 |
| Last Update Date | 2026-01-22 |