| NPI | 1508052614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 96960) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 22040) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2015-06-24 |