| NPI | 1992217707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 21401) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 37146) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2025-02-05 |