| NPI | 1639645740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8771) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 8771-33) |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2021-12-13 |