| NPI | 1790096642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 1098) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 104155) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |