| NPI | 1982956504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5090) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 143537) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2022-04-18 |