| NPI | 1700888930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2262-033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 111013-030) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-02-17 |