| NPI | 1861494882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND 203776) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP1654) |
| 363L00000X Nurse Practitioner (Licence: MN 13625) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2025-12-16 |