| NPI | 1104535038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13463-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 171290) |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2023-01-30 |