| NPI | 1093105660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 277421) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95033131) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 4046162) | |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2026-07-15 |