| NPI | 1144671660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6989-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 152913-30) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-08-19 |