| NPI | 1417393596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5449) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 134056) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2013-09-10 |