| NPI | 1780174664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 8540-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 218918-30) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2019-01-23 |