| NPI | 1811552623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 9375-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 164326-30) |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2020-06-25 |