| NPI | 1205426665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10277) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 10277-33) |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2022-03-16 |