| NPI | 1093141210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8614) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 063206-23) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60540782) | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2022-06-14 |