| NPI | 1104659671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 10885549-4405) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 10885549-3102) |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2026-06-12 |