| NPI | 1003365008 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7306-33) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 7306-33) | 
| Enumeration Date | 2016-10-02 | 
| Last Update Date | 2022-11-13 |