| NPI | 1003459769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9711-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 226077-30) |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2021-01-12 |