| NPI | 1255329835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 70053-030) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 70053-030) |
| Enumeration Date | 2005-10-08 |
| Last Update Date | 2015-12-11 |