| NPI | 1740694108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 6077-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 136047-30) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2017-12-04 |