| NPI | 1902518137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11023423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1193875) |
| 207Q00000X Family Medicine (Licence: MI 4704433093) | |
| 207Q00000X Family Medicine (Licence: IA a184108) | |
| 207Q00000X Family Medicine (Licence: LA 243089) | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2025-10-11 |