| NPI | 1073572004 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 1363) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 105239) | 
| Enumeration Date | 2006-03-20 | 
| Last Update Date | 2025-07-29 |