| NPI | 1124454830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5567-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 159374-30) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2021-02-19 |