| NPI | 1750009395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA 677272) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 857603) |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2026-01-05 |