| NPI | 1780076547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6315-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 184876-30) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 2014015292) | |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2018-11-01 |