| NPI | 1790379303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD R225911) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R229511) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2024-07-09 |