| NPI | 1912510173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R35577) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 7690) |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2025-06-03 |