| NPI | 1760996987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA H171254) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2018001756) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2025-02-03 |