| NPI | 1962739144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 3894) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 130625) |
| 363L00000X Nurse Practitioner (Licence: WI 3894) | |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2025-06-25 |