| NPI | 1588207765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 26625) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 61010275) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2026-07-02 |