| NPI | 1730966292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5018783) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC EDGE-LYWQZ) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2025-05-12 |