| NPI | 1598885709 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 154) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 92551-030) | 
| Enumeration Date | 2007-03-30 | 
| Last Update Date | 2022-04-21 |