| NPI | 1508215997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10045989) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12289) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP130857) | |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2025-06-19 |