| NPI | 1992303291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 5013663) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5013663) |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2021-12-29 |