| NPI | 1265828230 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 69134) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7738) | 
| 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0103406-C-NP) | |
| Enumeration Date | 2015-04-07 | 
| Last Update Date | 2025-04-17 |