| NPI | 1265220768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 17130-33) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 17130) |
| Enumeration Date | 2025-04-25 |
| Last Update Date | 2025-11-13 |