| NPI | 1912548595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NC 5012372) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5012372) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2025-06-10 |