| NPI | 1003366733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 11121) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A163915) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 8952) | |
| 363L00000X Nurse Practitioner (Licence: WI 11121-33) | |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2026-07-14 |