| NPI | 1053734723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5665-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 174804-30) |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2021-06-05 |