| NPI | 1164968608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 25808) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN629928) |
| 363L00000X Nurse Practitioner (Licence: PA SP017242) | |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2025-07-14 |