| NPI | 1649554239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 4621-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 149679-030) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2013-01-16 |