| NPI | 1225035124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 100520) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT RN28666) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2025-04-09 |