| NPI | 1114689692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 904895) |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2026-01-14 |