| NPI | 1942044219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5022834) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 30970) |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2025-09-23 |