| NPI | 1205459211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10202) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 228267) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2020-10-14 |