| NPI | 1316573173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007178) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO CAPN0003970) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1081153) | |
| Enumeration Date | 2020-03-12 | 
| Last Update Date | 2025-07-14 |