| NPI | 1053813964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112433) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A145171) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2025-08-29 |