| NPI | 1487380150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WY 50597) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 114273) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2025-12-08 |