| NPI | 1366944282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112421) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NE 112421) |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2026-06-24 |