| NPI | 1760952766 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000384) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11000384) | 
| Enumeration Date | 2018-12-03 | 
| Last Update Date | 2019-02-07 |