| NPI | 1043348998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 96-033) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: WI 82057-030) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2015-04-27 |