| NPI | 1790243582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AL 1-161924) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-161924) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2020-09-24 |