| NPI | 1225326010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4656) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 161733) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2011-10-19 |