| NPI | 1922997824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 265973) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 41533) |
| Enumeration Date | 2025-07-02 |
| Last Update Date | 2025-08-26 |