| NPI | 1194477760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL F07260051) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 21-757) |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2026-07-02 |