| NPI | 1306946066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WI 91259) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 1463) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2007-07-08 |