| NPI | 1124742903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13788) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 168049) |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2023-07-24 |