| NPI | 1932771714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10581) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: WI 158641-30) |
| 363LF0000X Nurse Practitioner Family (Licence: WI 10581) | |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2023-05-04 |