| NPI | 1700740511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11042456) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11042456) |
| Enumeration Date | 2025-12-15 |
| Last Update Date | 2026-06-11 |