| NPI | 1558605956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 21966) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 183256) |
| 363LF0000X Nurse Practitioner Family (Licence: WA AP60675860) | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2017-12-01 |