| NPI | 1245596154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NH R4639) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 13273-NP) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2025-08-23 |