| NPI | 1457920407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 11098) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 242572) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2022-03-03 |