| NPI | 1962175828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A182594) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021025129) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2025-03-31 |