| NPI | 1679537864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 102250) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1177) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2021-02-12 |