| NPI | 1750906855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11005402) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11005402) |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2023-01-11 |