| NPI | 1821658584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 227561) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RNP227561) |
| Enumeration Date | 2019-06-15 |
| Last Update Date | 2025-07-15 |