| NPI | 1619419900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 239565) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 888818) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2025-05-16 |