| NPI | 1912322900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008520) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN237519) |
| 163W00000X Registered Nurse (Licence: NC 179881) | |
| 163W00000X Registered Nurse (Licence: MA RN237519) | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2026-01-13 |