| NPI | 1871134783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 904580) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD 0245952) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2024-07-19 |