| NPI | 1083960843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4955) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 154169) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2021-11-24 |