| NPI | 1912682378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 11026751) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11026751) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2023-08-21 |