| NPI | 1306762695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 12304501-3102) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 12304501-3102) |
| Enumeration Date | 2026-06-29 |
| Last Update Date | 2026-08-06 |