| NPI | 1205143302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2010007957) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 151008-30) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2021-03-05 |