| NPI | 1023936705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN10049682) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1233621) |
| Enumeration Date | 2026-07-09 |
| Last Update Date | 2026-08-10 |