| NPI | 1972100766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025039863) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95026529) |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2026-02-24 |