| NPI | 1790499820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 38686) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WA AP61400324) |
| 363LF0000X Nurse Practitioner Family (Licence: ID 74424) | |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2025-08-24 |