| NPI | 1629759410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MS 856259) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 906093) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS 906093) | |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2025-02-14 |