| NPI | 1487360103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 18010-033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN761870) |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2026-02-11 |