| NPI | 1962927467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A121363) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 22752) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2025-04-10 |