| NPI | 1275640534 | 
|---|---|
| Doing Business As | |
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 88559-030) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1599-033) | 
| Enumeration Date | 2006-08-24 | 
| Last Update Date | 2025-06-05 |