| NPI | 1154724839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22680) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN253754) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2025-09-30 |