| NPI | 1942833868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012890) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 269057) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5012890) | |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2025-08-05 |