| NPI | 1104245604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-117974) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9380243) |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2025-12-19 |