| NPI | 1821680166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61391327) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 66742) |
| 363L00000X Nurse Practitioner (Licence: UT 14191887-4405) | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2025-10-09 |