| NPI | 1962249516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5022989) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 078109-23) |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2025-11-03 |