| NPI | 1164539656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 83636-030) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 781-033) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-11-23 |