| NPI | 1417149980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 3154033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 132681) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 3154) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2021-02-01 |