| NPI | 1205946266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4902-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101-0021171) |
| 163W00000X Registered Nurse (Licence: WI 191800-30) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA 238190) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-06-21 |