| NPI | 1134523830 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 884972)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS F0814571)  | 
| Enumeration Date | 2014-10-09 | 
| Last Update Date | 2024-04-08 |