| NPI | 1083454755 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 15675)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 23688530)  | 
| Enumeration Date | 2024-05-29 | 
| Last Update Date | 2024-12-18 |