| NPI | 1821166539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP925A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA NPPA070938) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201907779NP-PP) | |
| 363L00000X Nurse Practitioner (Licence: MT 102700) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2026-09-05 |