| NPI | 1740526516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10092) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 229746) |
| 363L00000X Nurse Practitioner (Licence: NC 229746) | |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2025-11-18 |