| NPI | 1164772943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5062) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 153231-30) |
| 363L00000X Nurse Practitioner (Licence: WI 153231-30) | |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2023-03-29 |