| NPI | 1649767054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2274536) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11040145) |
| 207Q00000X Family Medicine (Licence: OH APRN.CNP.0040441) | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2025-11-04 |