| NPI | 1104473065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24137) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012164) |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2025-11-10 |