| NPI | 1972177764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL APRN11005755) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11005755) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-01-25 |