| NPI | 1396582508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 907087) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 886603) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2025-07-11 |