| NPI | 1053976217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 243362) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 243362) |
| 363L00000X Nurse Practitioner (Licence: NC 243362) | |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2026-07-02 |