| NPI | 1194594218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 55764) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-263999) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 301719) | |
| Enumeration Date | 2023-12-29 |
| Last Update Date | 2026-06-16 |