| NPI | 1083609929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA 039850) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C039850) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2025-07-09 |