| NPI | 1114396892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WY 1529) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MT 48932) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2025-06-24 |