| NPI | 1093096448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 159179) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 4765) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2021-01-14 |