| NPI | 1700301074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7865-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 163353) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 7865-33) | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2020-09-11 |