| NPI | 1194153593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 8655) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8655) |
| 363L00000X Nurse Practitioner (Licence: AZ RN199051) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0098915) | |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2025-09-03 |