| NPI | 1730921776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5022855) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 274947) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2026-01-12 |