| NPI | 1790892149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 74585-030) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 376-033) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-11-22 |