| NPI | 1801159744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4807) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 147830) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-12-30 |