| NPI | 1962789826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AR 122223) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR 122223) |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2022-09-16 |