| NPI | 1083422596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5023623) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 29737) |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2026-01-07 |