| NPI | 1598623100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 17783-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 17783-33) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 17783-33) | |
| Enumeration Date | 2026-01-13 |
| Last Update Date | 2026-04-06 |