| NPI | 1679056121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP70089948) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9283365) |
| 363L00000X Nurse Practitioner (Licence: MD R235501) | |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2026-03-30 |