| NPI | 1275826547 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VI 200526)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN 0991677-np)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP12149)  | |
| Enumeration Date | 2011-05-19 | 
| Last Update Date | 2025-08-19 |