| NPI | 1316465867 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903599) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 903599) | 
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0000853-c-np) | |
| Enumeration Date | 2017-09-05 | 
| Last Update Date | 2025-07-14 |