| NPI | 1760064232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT NUR-APRN-LIC-175087) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-175087) |
| Enumeration Date | 2021-04-24 |
| Last Update Date | 2025-04-18 |