| NPI | 1003615543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R232531) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: MD CS00239) |
| 163W00000X Registered Nurse (Licence: MD R232531) | |
| Enumeration Date | 2025-03-08 |
| Last Update Date | 2025-10-15 |