| NPI | 1649292772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 2805) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 116807) |
| 363A00000X Physician Assistant (Licence: WI 2805) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2017-07-10 |