| NPI | 1528373693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 150645) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM 77040) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75615-92) | |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2025-08-11 |