| NPI | 1972339679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 15964) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WI 15964-33) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: WI 15964-33) | |
| 208800000X Urology (Licence: WI 15964-33) | |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2026-05-29 |