| NPI | 1407810005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 101053) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2631) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2012-03-20 |