| NPI | 1063495463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 113721) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MO 113721) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A153236) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2026-02-02 |