| NPI | 1447876750 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10250) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 200560-30) | 
| 363LF0000X Nurse Practitioner, Family (Licence: WI F06201389) | |
| Enumeration Date | 2020-06-23 | 
| Last Update Date | 2020-08-28 |