| NPI | 1033785530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11105-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 236210) |
| 363LF0000X Nurse Practitioner Family (Licence: WI 11105-33) | |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-08-30 |