| NPI | 1609199629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R874330) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 146976) |
| 363L00000X Nurse Practitioner (Licence: WA AP61679812) | |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2025-05-07 |