| NPI | 1962838607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA MA064217) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005150) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2025-07-17 |