| NPI | 1619699261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13269-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI Pending) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2022-11-01 |