| NPI | 1942844188 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2019055532)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11004903)  | 
| Enumeration Date | 2019-10-31 | 
| Last Update Date | 2022-11-09 |