| NPI | 1578540209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11034044) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 258167) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2025-01-13 |