| NPI | 1306410543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA H164730) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 113675) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2025-12-29 |