| NPI | 1063932473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009602) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 29753) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2025-12-22 |