| NPI | 1770164113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 2020167781) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11012001) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2022-10-11 |