| NPI | 1912559360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 227761) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 63629) |
| 363L00000X Nurse Practitioner (Licence: CT 16311) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201905669NP-PP) | |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2026-01-16 |