| NPI | 1689108490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009482) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 5009482) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 23559) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2025-09-10 |