| NPI | 1710750195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 906173) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA GAANP001688) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1140168) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95027199) | |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2025-10-30 |