| NPI | 1619153384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4212-033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 155-059-30) |
| Enumeration Date | 2008-01-12 |
| Last Update Date | 2021-11-29 |