| NPI | 1962180224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 114865) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A180963) |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2025-01-14 |