| NPI | 1831663905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61287424) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 25227) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 25227) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN0000025227) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP61287424) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AK 222108) | |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2025-11-24 |