| NPI | 1760056139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 30841) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 256194) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2026-03-02 |