| NPI | 1649713264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 158205) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 30849) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2025-08-20 |