| NPI | 1205205424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6649-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 168869) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-10-14 |