| NPI | 1790220044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 12223-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 232814 - 30) |
| 164X00000X Licensed Vocational Nurse (Licence: WI 319942) | |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2022-11-21 |