| NPI | 1174805022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5704) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 5704-33) |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2014-10-16 |