| NPI | 1700177110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13490-33) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R170619) |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2023-10-06 |