| NPI | 1235579780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 153350) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 153350) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2020-09-11 |