| NPI | 1760634554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 900159) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 2713A) |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2025-11-02 |