| NPI | 1902282270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19600) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 24643) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2025-08-18 |