| NPI | 1720403041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 168354) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 13715) |
| 363L00000X Nurse Practitioner (Licence: VA 0024193265) | |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2025-04-17 |