| NPI | 1164045092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10179-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 193403-30) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-07-22 |