| NPI | 1780067165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6138) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 6138) |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2017-01-05 |