| NPI | 1740702612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA AP09381) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: LA AP09381) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2022-05-26 |