| NPI | 1104287424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 6863-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 174540-30) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2016-03-14 |