| NPI | 1710613765 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 16624-33) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 31937) | 
| Enumeration Date | 2022-07-30 | 
| Last Update Date | 2025-09-05 |