| NPI | 1043838634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 65213) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 65213) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA 61371651) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: ID 65213) | |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2025-07-09 |