| NPI | 1518311455 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5019180) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71006873A) | 
| Enumeration Date | 2016-04-18 | 
| Last Update Date | 2025-03-27 |