| NPI | 1942060686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 15198-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 246279-30) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-04-05 |