| NPI | 1104668797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001926) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 908635) |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2025-10-09 |