| NPI | 1811998545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 1271) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 4470) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2021-01-12 |