| NPI | 1295817625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2365) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 2365) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2011-12-23 |