| NPI | 1568602530 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 3671) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 3671-033) | 
| Enumeration Date | 2009-03-03 | 
| Last Update Date | 2022-11-29 |