| NPI | 1174878839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4877) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 4877-33) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2021-12-13 |