| NPI | 1891773008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 600036) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 0006-00036) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2020-05-28 |