| NPI | 1588149629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8723-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 173303) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 8723-33) | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2021-01-14 |