| NPI | 1629175609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5016117) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F303710-1) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2026-01-08 |