| NPI | 1053897645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017371) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22057) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5017371) | |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2025-11-12 |