| NPI | 1790053338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP-1345A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-41966) |
| 363L00000X Nurse Practitioner (Licence: ID GNP26011A) | |
| Enumeration Date | 2011-12-10 |
| Last Update Date | 2025-03-20 |