| NPI | 1316546450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61115907) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704323149) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2025-01-06 |