| NPI | 1790291342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09612) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 09612) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2019-06-11 |