| NPI | 1134309230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13265-033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60816375) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R177824) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2023-01-04 |