| NPI | 1295980142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 152373) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 3574-33) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2013-10-02 |