| NPI | 1992156053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7049) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 7049-33) |
| 363L00000X Nurse Practitioner (Licence: WI 159315) | |
| 363L00000X Nurse Practitioner (Licence: IA A145082) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2022-07-12 |