| NPI | 1851332688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 9675) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-064032) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 0192371-22) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2019-12-05 |