| NPI | 1588111215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7499-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 126972) |
| Enumeration Date | 2016-09-11 |
| Last Update Date | 2017-02-08 |