| NPI | 1962202614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5022999) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11038112) |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-12-01 |