| NPI | 1194415752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018274) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC PAD-MKIQ2) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2024-12-03 |