| NPI | 1710656814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 17939) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61189955) |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2026-07-08 |