| NPI | 1770164113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 11012001) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11012001) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2026-03-12 |