| NPI | 1497579049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 1271066) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: WA AP61628105) |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2025-10-02 |