| NPI | 1932686581 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010743) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-153605) | 
| Enumeration Date | 2018-07-26 | 
| Last Update Date | 2025-04-18 |