| NPI | 1508247867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD AC007723) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08314) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11029902) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2025-10-30 |