| NPI | 1972003549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 8077-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 130765-30) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-02-20 |