| NPI | 1245057660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 5661072) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 49336) |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2025-12-04 |