| NPI | 1992274765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 29248) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012073) |
| 363L00000X Nurse Practitioner (Licence: NC 5012073) | |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2025-09-15 |