| NPI | 1326443144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6104) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 151228) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 6104) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2021-01-19 |