| NPI | 1962634428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 3814) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 120840 (RN)) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2020-09-11 |