| NPI | 1457351355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 26598) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 658-033) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2024-08-19 |