| NPI | 1104178110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5093) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 5093-33) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2021-10-13 |