| NPI | 1457991721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012713) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 248330) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2025-09-23 |