| NPI | 1891212536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 310408) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 007760) |
| 363L00000X Nurse Practitioner (Licence: MA RN240839) | |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2025-09-16 |