| NPI | 1306802723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 65990-30) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 528) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2012-02-23 |