| NPI | 1619978764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 118943-030) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 0371758-21) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2007-07-08 |