| NPI | 1174018584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8478-033) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 8478) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2019-08-21 |