| NPI | 1528087830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 1473) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 1473-33) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11005456) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-10-15 |