| NPI | 1225483944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 2014004353) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 175077-30) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 2014004353) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 2014004353) | |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |