| NPI | 1629603774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013176) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 278099) |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2025-08-02 |