| NPI | 1164350351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD 201134) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R043636) |
| Enumeration Date | 2026-05-11 |
| Last Update Date | 2026-06-26 |