| NPI | 1710665427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A175712) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 14778) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2026-03-11 |