| NPI | 1285157354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7807) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 145653-30) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 145653) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2021-12-06 |