| NPI | 1558876441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8124) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 8124) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 8124) | |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2019-06-25 |