| NPI | 1295300010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11138) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2021026788) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2024-08-07 |