| NPI | 1750155099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 16630) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP028639) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP028639) | |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2025-11-06 |