| NPI | 1033652201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009119) |
| Additional Taxonomies | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: NC 5009119) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2026-06-01 |