| NPI | 1164913406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8520-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 11599) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2021-08-11 |