| NPI | 1174822076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R877788) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 10054744) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2026-02-09 |