| NPI | 1649238270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 129159) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2666) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-04-05 |