| NPI | 1699072140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 4381) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 142621) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2011-12-30 |