| NPI | 1558502153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 10008-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 164441-030) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2022-06-28 |