| NPI | 1104290527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6752-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 192969-30) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2016-02-02 |