| NPI | 1063493666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 83716) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: WI 666033) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 83716) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2014-01-28 |