| NPI | 1962470757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 16192-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 089463) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2025-01-06 |