| NPI | 1164028650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10953) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A161171) |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2025-10-16 |