| NPI | 1962163618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11799-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 199977-30) |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-03-02 |