| NPI | 1114404118 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8329-33)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 8329-33)  | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 8329-33)  | |
| Enumeration Date | 2018-07-23 | 
| Last Update Date | 2021-01-13 |