| NPI | 1639498207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 149847-30) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 790737) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2016-06-27 |