| NPI | 1720568553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8636) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 8636-33) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2024-10-14 |