| NPI | 1649403395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 11673) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 4742-026) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2022-02-07 |