| NPI | 1336447846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4690) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 64549) |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2011-11-17 |