| NPI | 1770681025 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 1416-33) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1416) | 
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2020-12-03 |