| NPI | 1548134604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11042002) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 70045141) |
| Enumeration Date | 2025-10-01 |
| Last Update Date | 2025-10-01 |