| NPI | 1073399366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5019491) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 378845) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5019491) | |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2026-04-29 |