| NPI | 1730722166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 196508) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 196508) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2025-11-14 |