| NPI | 1205163920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5161-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 162176) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2019-01-04 |