| NPI | 1366296535 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 60318) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 60318) | 
| Enumeration Date | 2024-04-15 | 
| Last Update Date | 2025-10-09 |