| NPI | 1669237558 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R247779) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R247779) | 
| Enumeration Date | 2024-02-19 | 
| Last Update Date | 2024-03-06 |