| NPI | 1154438414 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 61991-030) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2514-033) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-12-03 |