| NPI | 1215303680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 19586) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5015546) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2025-01-07 |