| NPI | 1306368378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5019759) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP017597) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2025-01-08 |