| NPI | 1083449441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 15734) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1573433) |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2026-03-25 |