| NPI | 1457043630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5022773) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 28470A) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190001) | |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2025-08-08 |