| NPI | 1063700839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4539) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 157263) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2013-01-16 |