| NPI | 1144050279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5020661) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 301309) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5020661) | |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2025-09-12 |