| NPI | 1518493196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11046769) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP5149) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2026-07-14 |