| NPI | 1790444875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NM 73714) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 73714) |
| 363LF0000X Nurse Practitioner Family (Licence: FL 11017032) | |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2023-10-10 |