| NPI | 1942060967 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5020052) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5020052) | 
| Enumeration Date | 2024-03-19 | 
| Last Update Date | 2025-01-31 |