| NPI | 1063412799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2101-033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 2101033) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2015-08-19 |