| NPI | 1558688747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2009008877) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 4050-33) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2015-02-12 |