| NPI | 1790162717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 14266-33) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 6483-125) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2026-05-06 |