| NPI | 1154772150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008688) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 26441) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP027896) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024196936) | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2026-08-31 |