| NPI | 1891782850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 1755) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 68714) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 1755) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2014-05-21 |