| NPI | 1750257978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 8371586) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 8371586) |
| Enumeration Date | 2025-10-14 |
| Last Update Date | 2025-12-15 |