| NPI | 1790057560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 4767-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4767) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2025-09-22 |