| NPI | 1114589348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11034347) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 6678) |
| 363L00000X Nurse Practitioner (Licence: MN 6678) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2025-07-14 |