| NPI | 1912347170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 221761) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 6412) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP07415) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2015-08-31 |