| NPI | 1255740064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5829-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 161044-30) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2020-09-11 |