| NPI | 1164990396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: WA AP6168859) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3012589) |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2025-08-21 |