| NPI | 1679569826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 4412-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 78408-030) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-07-14 |