| NPI | 1750783494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 9287836) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9287836) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2025-01-22 |