| NPI | 1972068930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11017188) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: PA SP019951) |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2024-08-07 |