| NPI | 1861004194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11025500) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 10799) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2025-07-18 |