| NPI | 1407129893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4757-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 159134-30) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2020-01-07 |