| NPI | 1114933876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-178758) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 838) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-04-29 |