| NPI | 1245756089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7883) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 7150) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 788-33) | |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2023-07-17 |