| NPI | 1780240374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: UT 3104015-3102) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 3104015-8900) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 3104015-4405) | |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-28 |