| NPI | 1720563695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95017373) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VT 101-0135097) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209017774) | |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2025-02-15 |