| NPI | 1619302239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9680-033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 19724330) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2021-11-24 |