| NPI | 1093416398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A173415) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 12874) |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2025-06-09 |