| NPI | 1881100766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2017027611) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2017027611) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2025-12-01 |