| NPI | 1083664809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 1209) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 74082) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2009-04-27 |