| NPI | 1063970168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID 60947) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 60947) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2025-12-16 |