| NPI | 1265783443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5083-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 92258-30) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 5083-33) | |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2021-11-23 |