| NPI | 1912745506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020538) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5020538) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 127129) | |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2026-08-04 |