| NPI | 1972640068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 573-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 573-33) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 573-33) | |
| 163W00000X Registered Nurse (Licence: WI 105391-030) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2016-07-15 |