| NPI | 1164232195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 239516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 239516) |
| Enumeration Date | 2025-01-11 |
| Last Update Date | 2025-03-21 |