| NPI | 1063094357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10680-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95030137) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95030137) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11038885) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2025-07-17 |