| NPI | 1063137719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NE 114435) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 114435) |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2025-06-03 |