| NPI | 1700174125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 647233) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 17776530) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2019-01-04 |