| NPI | 1649369869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WA AP60660380) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704275881) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2017-03-28 |