| NPI | 1386379790 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A174346) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021042807) | 
| Enumeration Date | 2022-07-19 | 
| Last Update Date | 2025-07-14 |