| NPI | 1558478891 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 524-033) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 73049-030) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-08 |