| NPI | 1750713657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 18423) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006369) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 167075) | |
| 363L00000X Nurse Practitioner (Licence: NY 076924-23) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 18423) | |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2025-09-05 |