| NPI | 1407552623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 203305) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F349643-01) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2025-04-07 |