| NPI | 1104510809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14081)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 189901-30)  | 
| Enumeration Date | 2023-06-06 | 
| Last Update Date | 2023-09-05 |