| NPI | 1104373836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6907-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 4988) |
| Enumeration Date | 2016-09-11 |
| Last Update Date | 2022-10-25 |