| NPI | 1356958029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DC NP500023463) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC 0024194006) |
| 163W00000X Registered Nurse (Licence: MA RN2336320) | |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2025-12-19 |